January 27, 2012
“This study was based on publicly available information and self-reported data provided by the case study institution(s). The aim of Commonwealth Fund–sponsored case studies of this type is to identify institutions that have achieved results indicating high performance in a particular area of interest, have undertaken innovations designed to reach higher performance, or exemplify attributes that can foster high performance. The studies are intended to enable other institutions to draw lessons from the studied institutions’ experience that will be helpful in their own efforts to become high performers. Even the best-performing organizations may fall short in some areas or make mistakes—emphasizing the need for systematic approaches to improve quality and prevent harm to patients and staff.
“Between 4 percent and 5 percent of hospitalizations result in a health care–associated infection (HAI), at tremendous cost to individuals who become infected and those who fund health care. One of the most common and preventable HAIs is the central line–associated bloodstream infection (CLABSI), which can result when a central venous catheter is not inserted cleanly or maintained properly. An estimated 43,000 CLABSIs occurred in hospitals in 2009 and nearly one of five infected patients died as a result. This case study is part of a series that describes practices used by four leading hospitals that eliminated CLABSIs in their ICUs.”
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Infection control, Prevention and control | No Comments
January 24, 2012
“Background: The risk of infection following a visit to the emergency department is unknown. We explored this risk among elderly residents of long-term care facilities.
Methods: We compared the rates of new respiratory and gastrointestinal infections among elderly residents aged 65 years and older of 22 long-term care facilities. We used standardized surveillance definitions. For each resident who visited the emergency department during the study period, we randomly selected two residents who did not visit the emergency department and matched them by facility unit, age and sex. We calculated the rates and proportions of new infections, and we used conditional logistic regression to adjust for potential confounding variables.
Results: In total, we included 1269 residents of long-term care facilities, including 424 who visited the emergency department during the study. The baseline characteristics of residents who did or did not visit the emergency department were similar, except for underlying health status (visited the emergency department: mean Charlson Comorbidity Index 6.1, standard deviation [SD] 2.5; did not visit the emergency department: mean Charlson Comorbidity index 5.5, SD 2.7; p < 0.001) and the proportion who had visitors (visited the emergency department: 46.9%; did not visit the emergency department: 39.2%; p = 0.01). Overall, 21 (5.0%) residents who visited the emergency department and 17 (2.0%) who did not visit the emergency department acquired new infections. The incidence of new infections was 8.3/1000 patient-days among those who visited the emergency department and 3.4/1000 patient-days among those who did not visit the emergency department. The adjusted odds ratio for the risk of infection following a visit to the emergency department was 3.9 (95% confidence interval 1.4–10.8).
Interpretation: A visit to the emergency department was associated with more than a threefold increased risk of acute infection among elderly people. Additional precautions should be considered for residents following a visit to the emergency department.”
Posted in Journal Articles, READ Portal | Tagged with Health services for the aged, Infection control, Prevention and control, Safety | No Comments
December 16, 2011
“One of the most common types of health care–associated infections is the central line–associated bloodstream infection (CLABSI), which can result when a central venous catheter is not inserted or maintained properly. About 43,000 CLABSIs occurred in hospitals in 2009; nearly one of five infected patients died as a result. This report synthesizes lessons from four hospitals that reported they did not experience any CLABSIs in their intensive care units in 2009. Lessons include: the importance of following evidencebased protocols to prevent infection; the need for dedicated teams to oversee all central line insertions; the value of participation in statewide, national, or regional CLABSI collaboratives or initiatives; and the necessity for close monitoring of infection rates, giving feedback to staff, and applying internal and external goals. The report also presents ways these hospitals are spreading prevention techniques to non-ICU units, and strategies for preventing other health care–associated infections.”
Click here to read the full article
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Evidence-based, Prevention and control | No Comments
December 6, 2011
“A new study has a message for doctors and nurses who fail to wash their hands: Don’t think about yourself. Think about your patients.
Getting health care professionals to comply with notices to wash their hands before and after dealing with patients has been something of a thorn in the side of many hospitals. Although this simple measure limits the spread of sickness — and could potentially reduce the nation’s hospital health care bill by billions of dollars — many doctors and nurses simply ignore it. Compliance rates for hand washing in American hospitals are only around 40 percent, and years of awareness programs urging doctors to wash up or use disinfectant gels have had little effect.
Part of the problem, according to a forthcoming study in the journal Psychological Science, are the actual signs posted in hospital washrooms urging health care workers to wash up. Changing the message from “Wash Your Hands to Protect Yourself” to “Wash Your Hands to Protect Your Patients,” the study found, could motivate some doctors and nurses to wash their hands more frequently.”
The full study, titled “It’s Not All About Me: Motivating Hand Hygiene Among Health Care Professionals by Focusing on Patients” by Adam M. Grant and David A. Hofmann is available as an online release through Psychological Science. Ask your institution’s library for information on accessing the article.
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Posted in Mass Media Articles, READ Portal | Tagged with Hospital administration, Prevention and control, Safety | No Comments
November 2, 2011
This interactive toolkit is designed to support the goal of stopping preventable infections by providing access evidence-based information and tools in a number of formats. The website hosts documents with policy guides and references, as well as videos and presentations containing valuable information on easy-to-implement infection prevention and control measures.
Click here to access the toolkite
Posted in Multimedia, READ Portal | Tagged with Evidence-based, Prevention and control, Safety | No Comments
October 7, 2011
“The 2011 Stroke Evaluation Report provides a comprehensive review of stroke and transient ischemic attack (TIA) across the care continuum, including stroke prevention, emergency department care, acute inpatient care, inpatient rehabilitation and home care services, from 2003/04 to 2009/10. This information is used to assess the progress of the Ontario Stroke System (OSS) and identify gaps and opportunities for improvement.”
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Posted in READ Portal, Reports & Papers | Tagged with Efficiency, Prevention and control, Process improvement | No Comments
October 1, 2011
“The American Hospital Association (AHA) has established “strategic performance commitments” that identify specific targets for hospital efforts to improve patient care:
reduce central line-associated bloodstream infections (CLABSIs), eliminate preventable readmissions, and eliminate preventable mortality… Through its Hospitals in Pursuit of Excellence initiative, the AHA will provide advocacy, resources and research to America’s
hospitals to help them improve quality and patient safety and achieve these commitments. The Health Care Leaders Action Guide: Hospital Strategies for Reducing Preventable Mortality provides a broad overview of key steps that hospital and health system leaders should take in developing a strategy for reducing preventable mortality. Additional resources, covering all three commitments, can be found at www.hpoe.org.”
“Hospital leaders work hard every day to provide high quality care to the patients that they treat. They do this with the goal of providing care that is free of injury and harm. Nonetheless, much has been written about the numbers of patients that die unnecessarily in our nation’s hospitals. The publication of the 1999 landmark Institute of Medicine report, To Err is Human: Building a Safer Health System, brought attention to this problem with the estimation that between 48,000 and 98,000 deaths from medical errors occur each year in U.S. hospitals (IOM, 1999). Since then, much attention has been focused on ways to improve quality and patient safety. While most hospital deaths are not due to failures in care delivery, many deaths are preventable and this presents an important opportunity for hospital leaders to address. By collectively pursuing improvement strategies in a visible and measurable way, hospitals will be joining forces to advance a health care system that delivers the right care, to the right patient, in the right place. Hospital mortality is also an issue that easily resonates with the public.”
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Posted in READ Portal, Reports & Papers | Tagged with Prevention and control, Quality improvement, Risk management, Safety | No Comments
July 29, 2011
“Does your organization disclose medical errors when they occur? Does the practice of disclosure increase or decrease your liability costs?
The reported evidence from several medical centers indicates that there are both patient safety and financial benefits with disclosing medical errors. However, a widely reported and controversial expert study offers significant cautions about the disclosure route. This paper provides an overview of medical error disclosure, and analyzes the financial impact of disclosure on health care organizations.”
Posted in READ Portal, Reports & Papers | Tagged with Health care costs, Policy, Prevention and control | No Comments
June 7, 2011
“Hoping to reduce medication errors and contain health care costs, policy makers are promoting electronic prescribing through Medicare and Medicaid financial incentives. Many e-prescribing systems provide electronic access to important information—for example, medications prescribed by physicians in other practices, patient formularies and generic alternatives—when physicians are deciding what medications to prescribe. However, physician practices with e-prescribing face challenges using these features effectively, according to a new qualitative study by the Center for Studying Health System Change (HSC) funded by the Agency for Healthcare Research and Quality (AHRQ).
While most of the 24 practices studied reported that physicians had access to patient formulary information, only slightly more than half reported physician access to patient medication histories, and many physicians did not routinely review these sources of information when making prescribing decisions. Study respondents highlighted two barriers to use: 1) tools to view and import the data into patient records were cumbersome to use in some systems; and 2) the data were not always perceived as useful enough to warrant the additional time to access and review them, particularly during time-pressed patient visits. To support generic prescribing, practices typically set their system defaults to permit pharmacist substitution of generics; many practices also used other tools to more proactively identify and select generic alternatives at the point of prescribing. Overall, physicians who more strongly perceived the need for third-party data, those in practices with greater access to complete and accurate data, and those with easier-to-use e-prescribing systems were more likely to use these features consistently.”
Posted in Journal Articles, READ Portal | Tagged with e-health, Health technology, Prevention and control, Safety, Technology | No Comments
June 6, 2011
“Partnering to Heal is a computer-based, video-simulation training program on infection control practices for clinicians, health professional students, and patient advocates.
The training highlights effective communication about infection control practices and ideas for creating a “culture of safety” in healthcare institutions to keep patients from getting sicker. Users assume the identity of the following five main characters and make decisions about preventing healthcare-associated infections (HAIs):
- A Physician, Nathan Green, Director of a Hospital Post-op Unit, ready to start new prevention efforts in the unit;
- A Registered Nurse, Dena Gray, working to learn effective communications skills that could make the difference for her patients;
- An Infection Preventionist, Janice Upshaw, a new employee charged with using a team-based approach to reducing infections;
- A Patient Family Member, Kelly McTavish, whose father was just admitted to the hospital;
- A third-year Medical Student, Manuel Hernandez, who wants to gain confidence to make a difference for his patients.”
Posted in Multimedia, READ Portal | Tagged with Health technology, Infection control, Information technology, Patient-centered care, Prevention and control, Safety | No Comments
